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List Currently Showing Topic: Endodontics

A Clinically Relevant Review of Nickel Titanium Canal Enlargement
AGD Subject Code(s): 074 CE credits: 2 Cost: $49.00
Faculty: Richard E. Mounce, DDS
14498

Endodontic treatment has evolved greatly over the last two decades and has a high success rate when performed apropriately. The goal of endodontic treatment is the three dimensional cleansing, shaping, and obturation of the canal space from the canal orifice to the minor constriction of the apical foramen. It is generally considered that the single most important success factor in endodontic treatment is root canal preparation — the cleansing and shaping of the root canals prior to obturation. The mechanical shaping of root canal systems has been accomplished with a wide variety of methods and instruments. Canal instrumentation by hand was the first technique to be implemented and is still used today. Rotary nickel titanium (RNT) files became commercially available in the early 1990s for canal enlargement, and today RNT methods predominate in the developed world and among specialists. The use of RNT has enabled more centered canal preparations and fewer canal aberrations during preparation compared to previous techniques, and is efficient, systematic and safe when used appropriately. Depending on the design of RNT files, they can be more or less efficient and more or less resistant to breakage. File fracture can be the result of the properties of the alloy itself, and/or the clinician’s technique. RNT files are available as traditional ground nickel titanium files and as twisted files (TF). TF are the first RNT that can be efficiently and safely used as a single file technique, and offer different physical properties to traditional ground RNT. Regardless of the method and technique selected, the clinician must use an appropriate technique and great care when performing endodontic procedures.

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Achieving Predictable Success with Root Canal Treatment
AGD Subject Code(s): 074 CE credits: 2 Cost: $49.00
Faculty: William R. Watson Jr., DDS, MS, FAAOMP
14496

Root canal treatment is necessitated by endodontic disease, which is, in turn, a product of bacteria. Thus, the detection, management, and elimination of bacteria are of primary importance to the dental clinician. Every RCT procedure begins with a thorough diagnosis, including a complete clinical and radiographic examination. Following that, treatment of root canal systems consists of two phases: cleaning and shaping the access cavity to the canal, followed by its obturation. There are generally accepted sizes and shapes for the access cavity depending on the location of the tooth in question, but every case has its own unique requirements. The most common mistake in this stage of the process is to make the access cavity too small. Irrigants are essential when it comes to dissolving tissue, flushing bacteria, and cleaning the canal. Sodium hypochlorite (NaOCl) is the most widely used, often in combination with ultrasonic activation, although other irrigants, such as chlorhexidine and electrolyzed oxidized water, have their benefits as well. The second half of RCT, obturation, minimizes empty space inside the canal system and seals the canal. A monoblock of obturating material is recommended for a proper seal. Without this, even the best RCT procedure is undone. This article also includes a case study.

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Contemporary Endodontic Evaluation and Diagnosis: Implications for Evidence-Based Endodontic Care
AGD Subject Code(s): 070, 734 CE credits: 3 Cost: $49.00
Faculty: Manish Garala, BDS, MS
14387

Endodntics have evolved as a truly scientific procedure and, when correctly diagnosed and performed, its research-reinforced statistics corroborate its high success rates. In order for a correct diagnosis to be made, a number of steps and tests are required. These include ascertaining the source of the patient's chief complaint, understanding the patient's dental history and performing pulp tests that are integral to the diagnosis. In addition, the possibility of cracked teeth and periodontal involvement must be considered and assessed during the diagnostic phase. Only after a complete examination has been performed and a definitive diagnosis obtained is it possible to create a treatment plan for successful endodontic treatment.

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Implants or Endodontics: Alternative Treatments?
AGD Subject Code(s): 149 CE credits: 2 Cost: $49.00
Faculty: Fiona M. Collins, BDS, MBA, MA, Richard Nejat, DDS
14516

Reflecting improvements in oral health as well as changes in treatment modalities and patient expectations and preferences, the majority of current baby boomers in the United States will retain their natural teeth for life. The impact of an extraction varies with location, and options may include saving the tooth through endodontic treatment or extracting the tooth and placing an implant. Both implant therapy and endodontic therapy have good success rates. With both endodontic and implant therapy, success factors and considerations include the patient’s systemic and oral health, choice of materials, and technique used. A patient’s general health status may dictate which treatment is appropriate, overriding other factors. Considerations include medication use, infection risk and more generally the patient’s ability to withstand the treatment. Oral health considerations include caries experience, periodontal health, alveolar bone, occlusal load and bruxism, parafunctional habits, health of the remaining dentition, and the presence of or need for fixed prostheses. Determination of the appropriate treatment requires careful consideration of these and potential outcomes, with the patient participating in the process.

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Perspectives on Endodontic Therapy and Instrumentation
CE credits: 2 Cost: $49.00
Faculty: John C. Comisi, DDS, MAGD
14651

Endodontic treatment has as its overall goal the long-term retention and restoration of the endodontically treated tooth, including an absence of periapical infection. For this to be achieved, a number of steps and a careful technique are required during instrumentation and irrigation for cleansing and shaping of the canals, and during root canal obturation. Over time, root canal instrumentation options developed to include NiTi reamers and files, Gates Glidden drills, and other designs for manual and rotary use. Instrumentation options and techniques for obturation also increased to include traditional lateral and vertical cold condensation techniques, as well as techniques utilizing carriers and new materials. Regardless of which combination of instrumentation and techniques is used, successful endodontic therapy relies on a number of sequential steps that must be thoroughly carried out.

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Safety and Efficacy Considerations in Endodontic Irrigation
AGD Subject Code(s): 074 CE credits: 3 Cost: $59.00
Faculty: Gary Glassman, DDS, FRCD(C)
14457

Endodontic treatment is a predictable procedure with high success rates. Success depends on a number of factors, including appropriate instrumentation, successful irrigation and decontamination of the root canal space to the apices and in areas such as isthmuses. These steps must be followed by complete obturation of the root canals, and placement of a coronal seal, prior to restorative treatment. Several irrigants and irrigation systems are available, all of which behave differently and have relative advantages and disadvantages. Common root canal irrigants include sodium hypochlorite, chlorhexidine gluconate, alcohol, hydrogen peroxide and ethylenediaminetetraacetic acid (EDTA). In selecting an irrigant and technique, consideration must be given to their efficacy and safety.

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The Genesis and Development of CBCT for Dentistry
AGD Subject Code(s): 731 CE credits: 2 Cost: $49.00
Faculty: James Mah, DDS, DMSc, MS, BSc
14467

Cone beam computerized technology (CBCT) offers 3-dimensional visualization and more complex and more accurate imaging compared to analog and digital radiographs. It is an accurate tool for many clinical oral-maxillofacial indications, with lower radiation doses than computerized tomography. The clinician must determine the risk:benefit of imaging for each patient. Clinicians are rapidly realizing the significant advantages of CBCT imaging. Factors to consider in determining whether to purchase a CBCT device or to refer patients to imaging centers include cost, training, time required to generate images and reports, data transmission and storage, and responsibility for interpretation and pathology review.

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